Hybrid Medical Director — Health Services & Quality

Blue Cross Blue Shield of Arizona; Phoenix (AZ); Híbrido; USD 190.000 - 240.000; Jornada completa

Descripción de la vacante

Blue Cross Blue Shield of Arizona seeks a physician leader to oversee medical management activities, including utilization, case, disease and quality management. The role requires collaboration with physicians and hospitals to align medical policies with high standards of care.

The candidate must hold a Medical Degree, be licensed in Arizona, and possess Board Certification, with prior leadership and managed care experience in a clinical setting.

Formación

• 3 years of experience in a clinical setting
• 1 year of experience in physician leadership role, including quality review, utilization review and other managed care functions
• Active, current, and unrestricted license to practice medicine in the State of Arizona
• Board Certification

Responsabilidades

• Provide direction, senior medical oversight for utilization management, quality management, case management, medical claims review and pharmacy management.
• Lead consultations across divisions and communicate with stakeholders about complex cases and the impact of interventions.
• Enhance department efficiency through information systems and processes to reduce costs and improve care quality.
• Represent the organization at professional organizations and liaise with health care professionals and hospitals.
• Provide leadership to staff and medical peer committees and participate in appeals and grievance processes.

Conocimientos

Clinical leadership

Healthcare administration

Quality improvement

Educación

Medical Degree

Descripción del empleo

Blue Cross Blue Shield of Arizona seeks a physician leader to oversee medical management activities, including utilization, case, disease and quality management. The role requires collaboration with physicians and hospitals to align medical policies with high standards of care.

The candidate must hold a Medical Degree, be licensed in Arizona, and possess Board Certification, with prior leadership and managed care experience in a clinical setting.